Shift Work and the Risk of Cardiometabolic Multimorbidity Among Patients With Hypertension: A Prospective Cohort Study of UK Biobank

Abstract

Background Although the association between shift work and individual cardiometabolic diseases has been well studied, its role in the progression to cardiometabolic multimorbidity (CMM) remains unclear. In this study, we investigate the association between shift work and the incidence of CMM in patients with hypertension. Methods and Results This study is a population‐based and prospective cohort study on 36 939 UK Biobank participants. We used competing risk models to examine the association between shift work and the risk of CMM, which was defined as coexistence of hypertension and diabetes, coronary heart disease, or stroke in our study. We also investigated the association between the frequency and duration of shift work and CMM risks. In addition, we conducted a cross‐classification analysis with the combination of frequency and duration of shift work, chronotype and sleep duration as the exposure metrics. During a median follow‐up of 11.6 years, a total of 5935 participants developed CMM. We found that usually/always night shift workers were associated with a 16% higher risk of CMM compared with day workers (hazard ratio [HR], 1.16 [95% CI, 1.02–1.31]). We also found that a higher frequency of night shifts (>10/month) was associated with increased risk of CMM (HR, 1.19 [95% CI, 1.06–1.34]) that was more pronounced for >10/month in combination with a morning chronotype or <7 hours or >8 hours of sleep duration (HR, 1.26 [95% CI, 1.02–1.56]; HR, 1.43 [95% CI, 1.19–1.72], respectively). Conclusions We find that night shift work is associated with higher CMM risk in patients with hypertension.

Association Between Augmentation Index and Total Sleep Time in Night Shift Workers

“…Several epidemiological studies and meta-analysis have demonstrated that sleep duration of 6-8 h is associated with lower cardiovascular risk and mortality (Cappuccio et al, 2011; Yang et al, 2022). By contrast, we found that 5-6 h of sleep was related to better vascular characteristics, which seems to disagree with the aforementioned studies.…”

Association of shift work with incident dementia: a community-based cohort study

“…Furthermore, the work schedule information was assessed only at the baseline. Participants’ work status might change over time during the follow-up while people tend to stop doing shift or night shift work at an older age, which might bias our results toward the null hypothesis, resulting in an underestimation of the effect size [ 53 ]. Future prospective studies measuring the longitudinal change of employment status would be needed to assess the association of lifetime exposure to shift work with the risk of dementia.…”

Time‐restricted eating for chronodisruption‐related chronic diseases

“…Studies in shift workers demonstrated an association between shift work and vascular events like myocardial infarction and ischaemic stroke, and higher blood pressure. [83][84][85][86][87][88] Endogenous circadian clocks have been shown in vascular endothelial cells, vascular smooth muscle cells, fibroblasts, cardiomyocytes, and cardiac progenitor-like cells in the cardiovascular system of mice and humans. 89 Disruption of the light-dark cycle (10 h/10 h) inhibited the compensatory hypertrophy and normal remodeling of the cardiovascular tissue in the pressure overload cardiac hypertrophy mouse model.…”

“…Studies in shift workers demonstrated an association between shift work and vascular events like myocardial infarction and ischaemic stroke, and higher blood pressure 83–88 . Endogenous circadian clocks have been shown in vascular endothelial cells, vascular smooth muscle cells, fibroblasts, cardiomyocytes, and cardiac progenitor‐like cells in the cardiovascular system of mice and humans 89 .…”